Computed tomography imaging using split-bolus contrast injection with volume scan of aortic root and heart for preoperative evaluation of transcatheter aortic valve implantation.

The purpose of this study was to investigate using split-bolus contrast injection (SPBI) with volume scanning of the heart and aortic root with helical scanning of the access route, compared to single bolus contrast injection (SI) with variable helical pitch scanning (VHP) of the heart and aortic root and access route in a preoperative evaluation before transcatheter aortic valve implantation (TAVI). Thirty-five patients who underwent preoperative CT before TAVI using SPBI (contrast media: 24.5 mgI /kg/s, injected for 12 s for heart scan and then injected for 8 s for access route) were examined. Electrocardiogram (ECG) gated scans of the heart were performed by volume scan, after a period of time, non-gated helical scans of the aorto-iliac were performed (SPBI method). For comparison, 40 patients who had a single bolus injection (26.5 mg I/kg/s, injected for period of the scan time plus 3 s) and a VHP scan (SI method) before the SPBI method was performed were included in the study. The image qualities of the coronary arteries, aortic root, and access route (aorta-iliac), as well as radiation and iodine doses, were assessed. In visual assessment, image quality of coronary artery was significantly better with the SPBI method (grade; excellent: 57.1% in SPBI vs. 24.3% in SI, p = 0.03). There was no significant difference in image quality of the aortic root by visual assessment. The signal-to-noise (SNR) and contrast-to-noise ratio (CNR) of coronary and aortic root were not significantly different between the two methods. The access route showed significantly higher SNR (45.7 ± 11.5 vs. 34.3 ± 9.8, p < 0.001) and CNR (36.0 ± 9.7 vs. 28.0 ± 8.8, p < 0.001) for the SPBI method. The SPBI method compared to SI method reduced iodine dose by 10% and radiation dose by 45%. Preoperative CT imaging before TAVI using SPBI with volume scan is useful and can reduce iodine and radiation doses.

Change in annexin A3 expression by regulatory factors of hepatocyte growth in primary cultured rat hepatocytes.

We have recently reported that annexin (Anx) A3 expression is necessary for hepatocyte growth in cultured rat hepatocytes seeded at half the subconfluent density on collagen. In the present study, we investigated the effects of various regulatory factors of hepatocyte growth on AnxA3 expression. AnxA3 expression was significantly reduced in hepatocytes cultured under various growth inhibitory conditions such as presence of dexamethasone, culture at subconfluent cell density, and on EHS-Matrigel and lactose-carrying styrene polymer. On the other hand, hepatocyte growth factor and epidermal growth factor, stimulators of hepatocyte growth, significantly increased AnxA3 expression in hepatocytes cultured on EHS-Matrigel. These results show close correlation between known stimulatory or inhibitory actions of various factors to hepatocyte growth and increase or decrease in AnxA3 expression, and suggest the involvement of AnxA3 in their regulation of hepatocyte growth.